title: Infliximab dose reduction sustains the clinical treatment effect in active HLAB27 positive ankylosing spondylitis: a two-year pilot study.
abstract: The rationale of the study was to evaluate the efficacy of infliximab (IFX) treatment in patients with ankylosing spondylitis (AS) and to determine whether IFX dose reduction and interval extension sustains the treatment effect. Nineteen patients were included and treated with IFX 5 mg/kg every 6 weeks for 56 weeks. All patients concomitantly received MTX with median dose 7.5 mg/weekly. During the second year, the IFX dose was reduced to 3 mg/kg every 8 weeks. Eighteen patients completed the 1-year and 15 patients the 2-year trial. The ≥50% improvement at week 16 from baseline of BASDAI was achieved in 16/19 (84%) patients. Significant reductions in BASDAI, BASFI, and BASMI scores, decrease in ESR and CRP, and improvement in SF-36 were observed at weeks 16 and 56. The MRI-defined inflammatory changes in the sacroiliac joints disappeared in 10/15 patients (67%) already at 16 weeks. IFX treatment effect was sustained throughout the second year after IFX dose reduction and interval extension. We conclude that IFX treatment is effective in well-established active AS and a dose reduction sustains the treatment effect. These observations are of clinical importance and open the opportunity to reduce the drug costs.
authors.affiliation: Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy at Gothenburg University, Guldhedsgatan 10A, 41346 Gothenburg, Sweden.
authors.forename: Boel
authors.initials: B
authors.lastname: Mörck
authors.forename: Rille
authors.initials: R
authors.lastname: Pullerits
authors.forename: Mats
authors.initials: M
authors.lastname: Geijer
authors.forename: Tomas
authors.initials: T
authors.lastname: Bremell
authors.forename: Helena
authors.initials: H
authors.lastname: Forsblad-d'Elia
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D015796:HLA-B27 Antigen / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D000069285:Infliximab; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D012446:Sacroiliac Joint / Q000187:drug effects / Q000473:pathology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000378:metabolism*; D013997:Time Factors
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen; D000069285:Infliximab; D008727:Methotrexate